ACA’s Medicaid Expansion Associated with Greater Likelihood of Patients Receiving Optimal Care for Serious Surgical Conditions

Bottom Line: The Affordable Care Act’s (ACA’s) Medicaid expansion was associated with significant increases in insurance coverage among patients with serious surgical conditions such as appendicitis or aortic aneurysm, and a greater likelihood of these patients receiving timely, optimal care.
 
Why The Research Is Interesting: Lack of insurance coverage has been associated with delays in seeking care, more complicated diseases at the time of diagnosis, and a decreased likelihood of receiving optimal surgical care. The ACA’s Medicaid expansion has increased coverage among millions of low-income Americans, but its effect on care for common surgical conditions has not been known.
 
Who and When: 293,529 patients between the ages of 18 and 64 years with appendicitis, inflammation of the gallbladder, diverticulitis, peripheral artery disease or aortic aneurysm admitted to a hospital in 27 states that expanded Medicaid or 15 states that didn’t to compare outcomes before (2010-2013) and after Medicaid expansion (2014-2015)
 
What (Study Measures): State adoption of Medicaid expansion (exposure); presentation of patients with early, uncomplicated disease and optimal surgical management of their conditions (outcomes)
 
How (Study Design): This was an observational study. Researchers were not intervening for purposes of the study and they cannot control all the natural differences that could explain study findings.
 
Authors: Andrew P. Loehrer, M.D., M.P.H., University of Texas MD Anderson Cancer Center, Houston, and coauthors.
 
Results:  ACA’s Medicaid expansion was associated with increased insurance coverage of patients and improvement in receiving timely and optimal care for five common surgical conditions.
 
Study Limitations: Data are vulnerable to coding errors and study findings may not be generalizable for other medical conditions.
 
Study Conclusions:
 
 
For more details and to read the full study, please visit the For The Media website.
 
 
(doi:10.1001/jamasurg.2017.5568)